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MATERNITY HESI QUESTIONS
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MATERNITY HESI QUESTIONS
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MATERNITY HESI QUESTIONS WITHVERIFIED ANSWERS
m b
If MSAFP and estriol levels are low and the hCG level is high, results are positive for a possible
chromosomal defect.
Low levels of MSAFP and estriol and elevated levels of hCG found in the maternal blood sample are
indications of possible chromosomal defects. High levels of MSAFP and estriol in the blood sample after
15 weeks of gestation can indicate a neural tube defect, such as spina bifida and anencephaly, not
chromosomal defects. One of the limitations of the multiple marker screening is that any defects covered
by skin will not be evident in the blood sampling. After 15 weeks of gestation, there will be traces of
MSAFP, estriol, and hCG in the blood sample. - When returning for the results of her maternal serum
alpha-fetoprotein (MSAFP), a primigravida asks the nurse how problems with her baby can be detected
by the test. What information will the nurse give to the client to best describe how the test is
interpreted?
c
The FHR should be assessed before and after the procedure to detect changes that may indicate the
presence of cord compression or prolapse. An amniotomy (artificial rupture of membranes [AROM]) is
used to stimulate labor when the condition of the cervix is favorable. The fluid should be assessed for
color, odor, and consistency. Option A should be assessed every 15 to 20 minutes during labor but is not
specific for AROM. Option B is monitored hourly after the membranes are ruptured to detect the
development of amnionitis. Option D should be determined for all clients in labor. - The nurse is
preparing a laboring client for an amniotomy. Immediately after the procedure is completed, it is most
important for the nurse to obtain which information?
A.
Maternal blood pressure
B.
Maternal temperature
C.
,Fetal heart rate (FHR)
D.
White blood cell count (WBC)
c
The goal is to relieve pressure on the umbilical cord, and placing the client in a slight Trendelenburg
position is most likely to relieve that pressure. The FHR pattern is indicative of a variable fetal heart rate
deceleration, which is typically caused by cord compression and can occur with or without contractions.
Option A may be helpful to increase vascular space but is not as likely to relieve the pressure as the
Trendelenburg position. Option B is not helpful with cord compression. Option D is not the priority
intervention at this time. After repositioning the client, a vaginal examination is indicated to rule out
cord prolapse and assess for cervical change. - Six hours after an oxytocin induction was begun and 2
hours after spontaneous rupture of the membranes, the nurse notes several sudden decreases in the
fetal heart rate with quick return to baseline, with and without contractions. Based on this fetal heart
rate pattern, which intervention is best for the nurse to implement?
A.
Increase the IV fluids.
B.
Begin oxygen by nasal cannula at 2 L/min.
C.
Place the client in a slight Trendelenburg position.
D.
Assess for cervical dilation.
a
Mastitis, caused by plugged milk ducts, is related to breast engorgement, and breastfeeding during
mastitis facilitates the complete emptying of engorged breasts, eliminating the pressure on the inflamed
breast tissue. Option B is less painful but does not facilitate complete emptying of the breast tissue.
Option C will not relieve the engorgement on the affected side. Option D will not decrease antibiotic
effects on the infant. - A breastfeeding postpartum client is diagnosed with mastitis, and antibiotic
therapy is prescribed. Which instruction should the nurse provide to this client?
A.
,Breastfeed the infant, ensuring that both breasts are completely emptied.
B.
Feed expressed breast milk to avoid the pain of the infant latching onto the infected breast.
C.
Breastfeed on the unaffected breast only until the mastitis subsides.
D.
Dilute expressed breast milk with sterile water to reduce the antibiotic effect on the infant.
a
It is important that the hips of infants with hip dysplasia are maintained in an abducted position, which
can be accomplished by using the Pavlik harness; this keeps the hips and knees flexed, the hips
abducted, and the femoral head in the acetabulum. Early treatment often negates the need for surgery,
and option B is not indicated until approximately 6 months of age. Option C is not indicated for hip
dysplasia. It is best for the pediatrician to monitor hip joint mobility, and teaching the parents to perform
this technique is likely to increase their anxiety. - A newborn infant, diagnosed with developmental
dysplasia of the hip (DDH), is being prepared for discharge. Which nursing action should be included in
this infant's discharge teaching plan?
A.
Observe the parents applying a Pavlik harness.
B.
Provide a referral for an orthopedic surgeon.
C.
Schedule a physical therapy follow-up home visit.
D.
Teach the parents to check for hip joint mobility.
bc
Impaired bowel motility caused by surgical anesthesia, pain medication, and immobility is the priority
nursing diagnosis and addresses the potential problem of a paralytic ileus. Options A and B are both
caused by impaired bowel motility. Option D is not as important as impaired motility. - A client who
delivered by cesarean section 24 hours ago is using a patient-controlled analgesia (PCA) pump for pain
, control. Her oral intake has been ice chips only since surgery. She is now complaining of bloating. Which
nursing action takes the highest priority? (Select all that apply.)
A.
Call the health care provider to obtain an order to increase her diet.
B.
Administer the ordered magnesium hydroxide.
C.
Encourage her to change position every 30 minutes.
D.
Turn out the lights and discourage visitors.
E.
Encourage her to breast feed every two hours.
acef
Continuous breastfeeding on a 3- to 4-hour schedule during the day will cause a release of prolactin,
which will suppress ovulation and menses, but is not completely effective as a birth control method.
Option B is incorrect because alcohol can immediately enter the breast milk. Gas forming vegetables,
such as broccoli and onion, can cause the baby to have gases. Taking a warm shower will stimulate the
production of milk, which will be more painful after breastfeedings. Baby's will breastfeed until satisfied,
which may not empty the second breast and increase the risk for mastitis if breasts are not emptied.
Drinking fluids help establish supply of breast milk. - Which client statement indicates that she
understands the instructions of breastfeeding her newborn? (Select all that apply.)
A.
"Breastfeeding my infant consistently every 3 to 4 hours decreases the likelihood of me ovulating."
B.
"Breastfeeding my baby immediately after drinking alcohol is safer than waiting for the alcohol to clear
my breast milk."
C.
"I should avoid foods that usually give me gas."
D.
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